About Us:

Vault Health is a leading virtual-first healthcare platform that specializes in delivering remote diagnostics and specialty care to consumers directly, through their employers, and through their local public health agencies. Vault also leverages its virtual platform to facilitate decentralized clinical trials for companies in the Pharmaceutical and Biotech industries. Vault is a leading provider of at-home FDA-approved COVID-19 testing in the U.S., whose solution has been deployed to numerous local and state governments, airlines, universities, professional athletic teams, companies, and organizations. Today, Vault employs more than 500 employees across the country and expects to continue growing as we expand our products and services.

The Opportunity:

The Director of Payer Operations is responsible for leading the development of a go-to market strategy for Vault Medical Services. The Director will work cross functionally and externally to develop relationships with payers in new markets for Vault. This leader will be responsible for developing a strategy, negotiating rates and implementing a payer management system.

Responsibilities:

  • Conduct market analysis and research to develop a payor contracting strategy to maximize Vault’s market position.
  • Partner with internal and external stakeholders to lead negotiations and model financial expectations
  • Continually assess and make recommendations for new managed care opportunities.
  • Consult with key operational and clinical stakeholders to align on contract strategies.
  • Utilize your relationship skills to actively develop existing and new payer relationships.
  • Lead the implementation and communication strategy of new executed agreements.
  • Partner with revenue cycle operations on systemic issues and opportunities (e.g. denials, underpayments, and etc.).
  • Provide leadership to the integration of new joint ventures, affiliations and partnership arrangements.
  • Assess and review risks and opportunities across the enterprise related to payment reform, bundled payments, value-based payments, etc.
  • Establish and disseminate contracting guidelines with respect to third party payer contractual terms, reimbursement, provider enrollment and product participation.
  • Monitor market trends and advise senior leadership on methodologies for value-based programs, CMS models of payment and Medicaid programs.
  • Develop an ongoing strategy for Vault to engage in value-based programs.

Requirements:

  • 10 Years of Experience in payer contracting with provider organizations
  • Significant experience contracting with payers including financial analysis, payment methodologies and contract language
  • Bachelor’s Degree from four-year college or university 5 years or more of related experience. MBA preferred.
  • Are a self-starter and have the ability to operate independently.
  • Have experience developing and fostering payer relationships.
  • Have demonstrated experience in negotiating payer contracts.
  • Have the ability to manage multiple projects at once.
  • Understanding of fee-for-service and value-based payer contracting.
  • Have a strong analytical mindset.

Vault Health is an equal opportunity employer. All applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, national origin, age, disability, or veteran status.

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